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Matt Spraker: Some Radiation Oncology history…A battle of giants over proton therapy!

Photo of Matt Spraker from LinkedIn

Sep 23, 2023, 01:06

Matt Spraker: Some Radiation Oncology history…A battle of giants over proton therapy!

Matt Spraker, Radiation Oncologist at the University of Washington, made the following post on Twitter:

“Some Radiation Oncology history… A battle of giants over proton therapy! It started back in 2007 with an article published by Dr. Brada. The concern was that new centers started to open, perhaps ahead of sufficient clinical evidence.

The concerns were centered on the cost of a new center, which was substantial. In response, Dr. Goitein and Cox from Harvard and MDACC (at open proton centers) wrote an editorial. It is… direct to say the least. Unethical!

Further, they argue that radiation oncologists who demand randomized controlled trials are just cheap. Dr. Cox reports compensation from ProBeam, and I wanted to include that “yes, it *is* all about money” in our own editorial (2023). Co-authors smartly argued to be polite.

Back to 2008, Goitien and Cox triggered yet another editorial, this time from Glatstein, Glick, Kaiser, and Hahn (yes, of FDA fame). This predates the Penn Proton Center by 2 years, and no COI was reported.

Sometimes people like to point out that IMRT wasn’t really tested in randomized trials. I forgot about their answer, which is great. By the way, this editorial is mere months before our economic world crashed down. That world feels so distant.

All of these authors are greatly respected members of radiation oncology so where do we stand 15 years later? Certainly, the evidence we do have does not demonstrate clear superiority of protons in all settings. You have to wonder if Goitein and Cox would revise their conclusions.”

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Source: Matt Spraker / Twitter